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Regional brain dysfunction in insomnia after ischemic stroke: A resting-state fMRI study.

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Summary

Post-stroke insomnia (PSI) is linked to abnormal brain activity in visual, sensory, and default mode network regions. These changes, particularly DMN over-arousal, may explain insomnia and affect cognition and emotion.

Keywords:
amplitude of low-frequency fluctuationsfractional amplitude of low-frequency fluctuationfunctional magnetic resonance imagingpost-stroke insomniaregional homogeneity

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Area of Science:

  • Neuroscience
  • Medical Imaging
  • Sleep Medicine

Background:

  • Post-stroke insomnia (PSI) presents a significant challenge, impacting patient recovery and quality of life.
  • Understanding the underlying neuropathological mechanisms of PSI is crucial for developing effective treatments.

Purpose of the Study:

  • To investigate local brain function abnormalities in patients with PSI using functional MRI (fMRI).
  • To explore potential neuropathological mechanisms of PSI by correlating fMRI findings with Pittsburgh Sleep Quality Index (PSQI) scores.
  • To identify objective evaluation markers for future studies on acupuncture treatment for PSI.

Main Methods:

  • Recruited 27 patients with PSI and 27 healthy controls (HCs).
  • Collected resting-state fMRI and structural brain images.
  • Analyzed regional brain function using regional homogeneity (ReHo), amplitude of low-frequency fluctuations (ALFF), and fractional ALFF (fALFF).
  • Correlated fMRI metrics with PSQI scores.

Main Results:

  • PSI patients showed decreased ReHo in visual and sensorimotor cortices, and increased ReHo in the left supramarginal gyrus compared to HCs.
  • ALFF and fALFF analyses revealed widespread alterations in visual processing areas, temporal lobes, and limbic regions in PSI patients.
  • A negative correlation was found between ReHo in the left supramarginal gyrus and total PSQI score in the PSI group.

Conclusions:

  • PSI is associated with abnormal local brain activity in visual, sensorimotor, and default mode network (DMN) regions.
  • DMN over-arousal and heightened audiovisual stimulus sensitivity are potential key mechanisms driving PSI.
  • These neurobiological changes may concurrently impair cognitive function and emotion regulation in PSI patients.